Amid the challenges of adulthood, there is one rite of passage unique to the United States: the need to find your own health insurance by the time you turn 26.
That is the age at which the Affordable Care Act declares that young adults generally have to get off their family’s plan and figure out their own coverage themselves.
When the A.C.A. was voted into law in 2010, its so-called dependent coverage expansion was immediately effective, guaranteeing health insurance to millions of young Americans up to age 26 who would otherwise have not had coverage.
But for years, Republicans have whittled away at the infrastructure of the original law. Long gone is the requirement to buy insurance. Plans sold in the online insurance marketplaces have no stringent quality standards. Costs keep rising, and eligibility requirements and subsidies are a moving target.
The erosion of the law has now created an “insurance cliff” for Americans who are turning 26 and don’t have a job that provides medical coverage.
Some, scared off by the complexity of picking a policy and by the price tags, tumble over the edge and go without insurance, in a health system where the rate for an emergency room visit can be thousands, if not tens of thousands, of dollars.
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